Abstract
BackgroundUnder-five mortality is still a major health issue in many developing countries like Tanzania. To achieve the Sustainable Development Goal target of ending preventable child deaths in Tanzania, a detailed understanding of the risk factors for under-five deaths is essential to guide targeted interventions. This study aimed to investigate trends and determinants of neonatal, post-neonatal, infant, child and under-five mortalities in Tanzania from 2004 to 2016.MethodsThe study used combined data from the 2004–2005, 2010 and 2015–2016 Tanzania Demographic and Health Surveys, with a sample of 25,951 singletons live births and 1585 under-five deaths. We calculated age-specific mortality rates, followed by an assessment of trends and determinants (community, socioeconomic, individual and health service) of neonatal, postneonatal, infant, child and under-five mortalities in Cox regression models. The models adjusted for potential confounders, clustering and sampling weights.ResultsBetween 2004 and 2016, we found that neonatal mortality rate remained unchanged, while postneonatal mortality and child mortality rates have halved in Tanzania. Infant mortality and under-five mortality rates have also declined. Mothers who gave births through caesarean section, younger mothers (< 20 years), mothers who perceived their babies to be small or very small and those with fourth or higher birth rank and a short preceding birth interval (≤2 years) reported higher risk of neonatal, postneonatal and infant mortalities.ConclusionOur study suggests that there was increased survival of children under-5 years in Tanzania driven by significant improvements in postneonatal, infant and child survival rates. However, there remains unfinished work in ending preventable child deaths in Tanzania.
Highlights
Under-five mortality is still a major health issue in many developing countries like Tanzania
Post-neonatal, infant, child and under-five mortalities Between 2004 and 2016, the analysis showed that neonatal mortality rate (NMR) has remained relatively unchanged, while Postneonatal mortlaity rate (PMR) has halved, a decrease of 54%, from 35 deaths per 1000 live births in 2004 to 16 deaths per 1000 live births in 2016
Infant mortality rate (IMR) decreased by approximately 37%, from 62 deaths to 39 deaths per 1000 live births; child mortality rate (CMR) fell by 48%, from 50 deaths to 26 deaths per 1000 live births, and Under-five mortality rate (U5MR) declined by 42%, from 109 deaths to 63 deaths per 1000 live births over the study period [Fig. 1]
Summary
Under-five mortality is still a major health issue in many developing countries like Tanzania. To achieve the Sustainable Development Goal target of ending preventable child deaths in Tanzania, a detailed understanding of the risk factors for under-five deaths is essential to guide targeted interventions. This study aimed to investigate trends and determinants of neonatal, post-neonatal, infant, child and under-five mortalities in Tanzania from 2004 to 2016. In the past four decades, considerable reductions in under-five mortality have occurred globally, with significant improvements in child survival in many countries. In the postMDG period, the global community has agreed on a new set of targets, the Sustainable Development Goals (SDGs), with SDG-3.2 aiming to reduce under-five mortality to at least as low as 25 per 1000 live births by the year 2030 [5]. The SDG agenda focuses on both developed and developing countries, SDG-3.2 is relevant for developing countries given the current estimate of U5M in developed countries [2]
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